GLP-1 Analog Counteracts Antipsychotic-Induced Glucose Intolerance, Weight Gain
Liraglutide significantly improved glucose tolerance, body weight, and other cardiometabolic disturbances in patients who have disorders on the schizophrenia spectrum.
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Liraglutide significantly improved glucose tolerance, body weight, and other cardiometabolic disturbances in clozapine- or olanzapine-treated patients who have disorders on the schizophrenia spectrum, according to research presented at the American Diabetes Association 77th Scientific Sessions, held June 9-13 in San Diego, California.
Although patients with schizophrenia have higher mortality rates compared with the background population (primarily caused by cardiovascular disease), interventions seeking to counteract antipsychotic-induced weight gain and cardiometabolic disturbances have had limited success. As a result, Louise Vedtofte, of Gentofte Hospital, Københavns Universitet, in Copenhagen, Denmark, and colleagues investigated the effects of glucagon-like peptide-1 liraglutide in obese/overweight patients with prediabetes and schizophrenia spectrum disorders on stable treatment with clozapine or olanzapine.
In a 16-week, placebo-controlled double-blind trial of 103 patients randomly divided into comparable groups, the researchers gave 1.8 mg/d of liraglutide to participants (6 dropped out). Glucose tolerance improved with liraglutide (P <.001) compared with no change with placebo (P =.95; between group P <.001).
In the liraglutide-treated group, 63.8% of the participants developed normal glucose tolerance compared with 16.0% of the placebo-treated participants (P <.001; number-needed-to-treat=2). Body weight decreased with liraglutide (-4.7±0.5 kg) and increased with placebo (+0.5±0.7 kg; P <.001).1
Other results confirmed that liraglutide was well tolerated as well: reductions in waist circumference (-4.0±0.6 vs 0.5±0.7 cm; P <.001), systolic blood pressure (-1.4±2.0 vs 1.1±1.8 mm Hg; P =.04), visceral fat (-315.8±75.3 vs -24.0±41.7 g; P =.02), and low-density lipoprotein cholesterol (-0.4±0.08 vs -0.06±0.05 mmol/L; P <.001) were significantly greater with liraglutide compared with placebo. Adverse events with liraglutide were primarily gastrointestinal, and serious adverse events were significantly lower in the liraglutide-treated group (12% vs 26%; P =.04).
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Vedtofte L, Larsen JR, Jakobsen MSL, et al. The GLP-1 analog liraglutide improves glucose tolerance and reduces body weight in schizophrenia spectrum disorder patients treated with clozapine or olanzapine. Presented at: American Diabetes Association 77th Scientific Sessions; June 9-13, 2017; San Diego, CA. Abstract 129-OR.